{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:09:01Z","timestamp":1785658141644,"version":"3.56.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,8,15]],"date-time":"2013-08-15T00:00:00Z","timestamp":1376524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"University of Pittsburgh Medical Center Competitive Medical Research Fund","award":["W81XWH-11-2-0133"],"award-info":[{"award-number":["W81XWH-11-2-0133"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Steatosis is a defining feature of nonalcoholic fatty liver disease (<jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>). However, evidence that severity of steatosis can predict adverse outcomes in <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> or nonalcoholic steatohepatitis (<jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>) is lacking. The aim of this study was to determine whether steatosis assessed by computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) imaging predicts adverse outcomes in diabetic patients at risk for <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied deaths, liver\u2010related and cardiovascular adverse outcomes in a 5\u2010year retrospective observational cohort of 2343 type 2 diabetic patients in a large care network who had noncontrast <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> imaging for clinical indications. We measured steatosis by subtraction of spleen from liver attenuation, a method that showed low sensitivity (0.417) and high specificity (0.882) compared with histopathological scoring. We evaluated outcomes prediction using multivariate <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox proportional hazards modelling of steatosis both as a categorical (\u226530%) and continuous variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Steatosis \u226530% was present in 233 (9.9%) of the cohort at baseline. Over 5\u00a0years, there were 372 total deaths, 18 liver\u2010related and 99 cardiovascular deaths, 48 liver transplants, 51 occurrences of hepatic encephalopathy, 41 hepatocellular carcinomas, 653 myocardial infarctions, 66 strokes, 180 occurrences of angina, 735 occurrences of arrhythmia and 772 occurrences of congestive heart failure. Steatosis had no predictive value for any adverse outcome. Patients with steatosis averaged 8\u00a0years younger than those without it. Age had a strong covariate influence on occurrence of total deaths, cardiovascular deaths, myocardial infarctions, arrhythmias and congestive heart failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although steatosis on imaging is often the abnormality that triggers diagnosis and assessment of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>, it lacks predictive value for adverse clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12285","type":"journal-article","created":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T14:54:17Z","timestamp":1375196057000},"page":"1575-1582","source":"Crossref","is-referenced-by-count":21,"title":["Hepatic steatosis in diabetic patients does not predict adverse liver\u2010related or cardiovascular outcomes"],"prefix":"10.1111","volume":"33","author":[{"given":"Michael A.","family":"Dunn","sequence":"first","affiliation":[{"name":"Center for Liver Diseases Division of Gastroenterology, Hepatology and Nutrition Department of Medicine University of Pittsburgh Pittsburgh PA USA"},{"name":"Department of Biomedical Informatics University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaideep","family":"Behari","sequence":"additional","affiliation":[{"name":"Center for Liver Diseases Division of Gastroenterology, Hepatology and Nutrition Department of Medicine University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari S.","family":"Rogal","sequence":"additional","affiliation":[{"name":"Center for Liver Diseases Division of Gastroenterology, Hepatology and Nutrition Department of Medicine University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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Biomedical Informatics University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyongtae T.","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh Pittsburgh PA 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